CGH Mat Fax CGH Surgical Floor Fax
Subject:
Updated December 27th 2023 for use in primary care by Dr. John Robertson, licensed under the GNU General Public License, version 2(GPLv2)

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Insert Current Rx Insert Recent Rx Own Meds RhoGam Orders
IVP Dye Allergy MTX for Ectopic
Antepartum Admit PPROM < 32 weeks Intrapartum Admit
NVP Inpatient NVP Outpatient Mid Trimester Loss
Misoprostol Induction
2100kcal no labour NPO no labour GDM Labour I Drip orders GDM In Labour No I Drip Insulin Sliding Scale PP-GDM PP-Type2DM
PP-Type1DM
AntePartum PostPartum
(import missing eForm here )
Mandatory Orders Cefazolin Probenecid Cefazolin Cephalexin
Clindamycin Ceftriaxone Vancomycin Gentamycin
‡Ertapenem-Restricted Drug‡ Other Reassessment
Wound Care Other Referral ID Consulted
Fraser Health may refuse a regular order sheet and require a pre printed order sheet: (import missing eForm here )
For febrile neutropenia, please use the Febrile Neutropenia PPO (latest version of Form ID:DRD0105161
Preamble-mandatory
--Carbapenem--Pick indication then drug
Indication Carbpenem CNS Indication Carbpenem CF
Indication Carbpenem Other
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meropenem Q6 meropenem eGFR less than 50 meropenem CNS-CF
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Imipenem Q6 Imipenem eGFR less than 50
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‡ertapenem‡ ‡ertapenem eGFRless than 30‡
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--linezolid--Pick indication then dose
Indication linezolid-bacterial resistance
Indication linezolid-patient intolerance Indication linezolid-other
linezolid-PO linezolid-IV
--daptomycin--Pick indication then dose
Indication bacterial resistance Indication linezolid-patient intolerance
Indication daptomycin-other
daptomycin dose

ID Consulted
Cellulitis - Non Purulent incl acute mild diabetic foot
Cellulitis / Know or suspected MRSA
Diabetic Foot Infection - Mod - severe or chronic long standing
UTI-Pyelonephritis
Cat or Dog Bite
Peritonsilar/Periodontal abscess
Vancomycin Dose+Interval
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